Spacing of cue-approach training leads to better maintenance of behavioral change

The maintenance of behavioral change over the long term is essential to achieve public health goals such as combatting obesity and drug use. Previous work by our group has demonstrated a reliable shift in preferences for appetitive foods following a novel non-reinforced training paradigm. In the current studies, we tested whether distributing training trials over two consecutive days would affect preferences immediately after training as well as over time at a one-month follow-up. In four studies, three different designs and an additional pre-registered replication of one sample, we found that spacing of cue-approach training induced a shift in food choice preferences over one month. The spacing and massing schedule employed governed the long-term changes in choice behavior. Applying spacing strategies to training paradigms that target automatic processes could prove a useful tool for the long-term maintenance of health improvement goals with the development of real-world behavioral change paradigms that incorporate distributed practice principles.

Mechanisms of Choice Behavior Shift Using Cue-approach Training

Cue-approach training has been shown to effectively shift choices for snack food items by associating a cued button-press motor response to particular food items. Furthermore, attention was biased toward previously cued items, even when the cued item is not chosen for real consumption during a choice phase. However, the exact mechanism by which preferences shift during cue-approach training is not entirely clear. In three experiments, we shed light on the possible underlying mechanisms at play during this novel paradigm: (1) Uncued, wholly predictable motor responses paired with particular food items were not sufficient to elicit a preference shift; (2) Cueing motor responses early – concurrently with food item onset – and thus eliminating the need for heightened top–down attention to the food stimulus in preparation for a motor response also eliminated the shift in food preferences. This finding reinforces our hypothesis that heightened attention at behaviorally relevant points in time is key to changing choice behavior in the cue-approach task; (3) Crucially, indicating choice using eye movements rather than manual button presses preserves the effect, thus demonstrating that the shift in preferences is not governed by a learned motor response but more likely via modulation of subjective value in higher associative regions, consistent with previous neuroimaging results. Cue-approach training drives attention at behaviorally relevant points in time to modulate the subjective value of individual items, providing a mechanism for behavior change that does not rely on external reinforcement and that holds great promise for developing real world behavioral interventions.

Influencing food choices by training: evidence for modulation of frontoparietal control signals

To overcome unhealthy behaviors, one must be able to make better choices. Changing food preferences is an important strategy in addressing the obesity epidemic and its accompanying public health risks. However, little is known about how food preferences can be effectively affected and what neural systems support such changes. In this study, we investigated a novel extensive training paradigm where participants chose from specific pairs of palatable junk food items and were rewarded for choosing the items with lower subjective value over higher value ones. In a later probe phase, when choices were made for real consumption, participants chose the lower-valued item more often in the trained pairs compared with untrained pairs. We replicated the behavioral results in an independent sample of participants while they were scanned with fMRI. We found that, as training progressed, there was decreased recruitment of regions that have been previously associated with cognitive control, specifically the left dorsolateral pFC and bilateral parietal cortices. Furthermore, we found that connectivity of the left dorsolateral pFC was greater with primary motor regions by the end of training for choices of lower-valued items that required exertion of self-control, suggesting a formation of a stronger stimulus-response association. These findings demonstrate that it is possible to influence food choices through training and that this training is associated with a decreasing need for top-down frontoparietal control. The results suggest that training paradigms may be promising as the basis for interventions to influence real-world food preferences.